When Dr. John Gilmore and his colleagues launched the UNC Early Brain Development Study 20 years ago, they were seeking to understand abnormalities of early brain development in children at high risk for schizophrenia. This focus on the brain development of young children was unique at the time, as schizophrenia does not typically present until late adolescence or early adulthood. However, by the time the actual symptoms of schizophrenia present in the form of psychosis, the implications can 
the trajectory of a patient’s life. The UNC Early Brain Development Study was and is a first step on the path to treat those at high risk for schizophrenia before the symptoms of psychosis begin by identifying early markers of risk in a child’s brain development.
The Early Brain Development Study was the first of its kind—the first to do MR imaging to look at brain development in children at risk of schizophrenia and the first longitudinal study. “It’s the only study like this in the world as far as I know,” says Dr. Gilmore, the Thad and Alice Eure Distinguished Professor, Vice Chair for Research and Scientific Affairs, and Director of the Center for Excellence in Community Mental Health.
Dr. Gilmore describes the “moonshot” of the UNC Brain Development Study as being able to identify when the abnormalities express themselves and then suggest early interventions that might mitigate the risk of schizophrenia. People with schizophrenia tend to have cognitive impairment, such as lower IQ or problems with memory. This cognitive impairment is present in childhood, with some children being significantly behind in cognitive development by age two. Something as simple as an early intervention that addresses cognitive disparity in a toddler may actually reduce that child’s risk for psychosis in adolescence. At this point, the potential interventions are only theoretical. However, the study has led to important findings about brain development itself; for instance, the fundamental architecture of a child’s brain is established by age one or two.
Dr. Gilmore thinks his team is about 10 years away from understanding whether specific early interventions will actually mitigate risk for children at high risk for schizophrenia. “When we first started this study, we were one of the first to image babies. We were just trying to prove that you could do it,” he shares. Now that the babies who were first imaged are 14 years old, Dr. Gilmore is thinking about where they may go next. The advent of artificial intelligence is an opportunity to better understand the non-genetic factors that shape a child’s brain and how they interact with genetic risk. Through AI technology, the team can develop models that predict how an environmental factor such as access to healthy food, a supportive and stimulating home environment, or strong social bonds will shape a child’s brain, ultimately predicting brain development. A better understanding of the role of environmental factors could lead to more tailored interventions for those at risk for schizophrenia. Dr. Gilmore sees this as the next frontier of his team’s research, but it is one that will require new resources and financial investments. If the initial findings of the UNC Early Brain Development Study are any indicator of the potential for success, philanthropic support of artificial intelligence modeling could be a game changer.
For more information on how to support research programs such as the UNC Early Brain Development Study, please contact Ed Binanay, Director of Development, 919-962-1989 or edward_binanay@med.unc.edu.